National Centre for Cell Science, Pune s1

NATIONAL CENTRE FOR CELL SCIENCE, PUNE (An autonomous Institution of the Department of Biotechnology, Government of India) NCCS Complex, Pune University Campus, Ganeshkhind, Pune - 411007, Maharashtra, India.

APPLICATION FOR THE POST OF…………………. Note: - FILL UP ALL DETAILS IN BLOCK LETTERS. (Incomplete form will not be entertained)

01. Name (SURNAME- NAME -MIDDLE 06.I) NAME)Permanent Address along *Valid Affix latest 02. Name of Father/Spouse with City Pin Code No., Telephone/Mobilepassport 03. Advt.City/Village, No. , Applied District, Post State & Number(s):size Post& Country. Sr. No. photograp 06.II)04. DateCorrespondence of Birth Address h 05. Agealong as onwith (20.01.2015) City Pin Code No., City/Village, District, State & Country. 06.III) *Valid E-Mail Address: *Please make sure that the e-mail id & mobile number is correct and legible.

07. Gender: 08. Marital status:

09. Nationality: 10. Whether SC/ST/OBC/

10. A) For OBC –Specify Latest Non Creamy Layer Cert. validity date:

11. Additional Qualifying Examination(s) passed (A) CSIR/UGC- NET/LS (B) GATE/DBT-JRF (Category-II Fellowship) Registration/Roll No.: Registration/Roll No.: Date of exam: Date of exam: Valid till: Valid till: Year of Passing: Year of Passing:

12. Educational Qualification: (Starting from SSC onwards) Degree/ Name of the Subjects/Spe Total Marks Percent Month & Examination Board/Universi cialization Obtained/Ou age / Year of passed ty t of Grade passing

13. Experience: (Starting from the present/immediate last employer) Name of the organization, Period Scale of Pay & Reasons Post Held & reporting Nature of Gross for guide/head/in- charge Job Emoluments Leaving officer From To

14. Title of the Ph. D. thesis:

15. Research Publications with full references (if any):

16. I am herewith submitting my post preferences:

Posts Post Sr. No. Post Sr. No. Post Sr. No. Post Sr. No. Post Sr. No. 1st 2nd 3rd 4th 5th Preference Preference Preference Preference Preference RA/SRF (Strike out whichever is not applicable) JRF (Strike out whichever is not applicable)

RS-Research Scientist/RA-Research Associate / PDF-Post-Doctoral Fellow / SRF-Senior Research Fellow / JRF-Junior Research Fellow / PA-Project Assistant/ AA-Admin Assistant/RA-Research Assistant/PF-Project Fellow

DECLARATION

I hereby declare that I have carefully read the instructions and particulars supplied to me and that the entries made in this application form are correct to the best of my knowledge and belief.

Date: - Signature of the Candidate